State Health Insurance

Patient Protection and Affordable Care Act

Health Plan Options

CMS/SEGIP: The State of Illinois department of Central Management Service (CMS) offers health insurance to faculty and staff who meet the eligibility criteria for the Illinois State Employees Group Insurance Program (SEGIP).

The Patient Protection and Affordable Care Act (PPACA) is the major healthcare reform enacted on March 23, 2010. PPACA requires large employers like the University of Illinois to offer health insurance coverage to substantially all (at least 95%) of their full-time employees, which for this purpose is defined as averaging 30 or more hours per week. Additionally, PPACA requires the University to complete complex annual IRS reporting. These requirements make it critically important for the University to be able to track hours for all employees. See FAQs for Tracking and Measuring Work Hours.

PPACA also requires nearly all individuals with income above the tax-filing threshold to obtain health coverage. Other changes involved insurance plan provisions and coverage requirements, such as the elimination of pre-existing conditions, the extension of dependent coverage for children up to age 26, the prohibition of lifetime limits on essential health benefits, and including the value of your health insurance plan on your W-2.

Tax Forms

Benefits-eligible employees will see health insurance value information on their W-2. Full-time employees will also receive a new statement of coverage for tax purposes.

PPACA & W-2
The Patient Protection and Affordable Care Act (PPACA) requires employers to report the value of health insurance coverage on employees' W-2 forms. The purpose of the value of health coverage, as stated by the IRS, is to provide employees useful and comparable consumer information on the cost of health care coverage. This amount is not taxable and does not include the value of dental or life coverage.

The value of health insurance was reported by the Group Insurance Division to the Comptroller, SURS, and all universities and appears in box 12 of the W-2 form with the code 'DD'. The amount reported includes any pay period from January through December in which the employee had income that was reported on a state agency or state university W-2.

PPACA & 1095-C
The Patient Protection and Affordable Care Act (PPACA) requires employers to offer health insurance coverage to full-time employees and their child dependents. Employers must send an annual statement (on paper or electronically) to eligible employees describing the health insurance coverage that was offered to them. The IRS Form 1095-C serves as that statement.

IRS Regulations provide the opportunity to consent to receiving the 1095-C electronically in the same manner that you consent and receive your W-2 electronically each year. University Payroll & Benefits (UPB) is working with a vendor to make this 1095-C electronic consent option available for 2015 reporting. UPB will email employees with further information regarding the issuance of the 2015 Form 1095-C.

Who to Contact with Questions

If you are unsure whether you are eligible for health insurance coverage based on your University employment, please contact your supervisor or your unit's hiring manager.